Open Letter to Rt Hon Jacinda Ardern

Dear Prime Minister,

Today is International Day of the Midwife. Normally I would write in a formal tone but to be honest, I’m too exhausted to come up with the words. I can barely think so you’ll need to excuse me writing from the heart. Perhaps you can appreciate that more – I certainly appreciate that you role model kindness and compassion.

Actually, I’m beyond exhausted. And I’m not even a midwife. I’m an (unpaid) volunteer for Auckland HomeBirth Community and since lockdown started, I have had to squeeze every waking moment I have to helping support the sudden increase in people birthing at home.

I can only imagine how hard it is for our midwives at the moment. Even before the lockdown, they were in crisis with falling numbers, ever increasing workloads and not being paid enough to live by. Funnily enough babies will be born when they’re born regardless of a midwife shortage, regardless of COVID-19, regardless of anything. Now midwives have to deal with increased hygiene protocols, not having enough PPE, a barrage of questions they can’t answer, changing the way they give care, inconsistent hospital protocols, lack of information… Midwives who are so passionate, so kind, so full of love for what they do, helping women, families and babies, are working beyond what any one person should have to bear even when they don’t get paid, even when it comes at a profound cost to them.

These are the words of one such midwife (who would prefer to stay anonymous) on what is has been like for her:

When Covid 19 hit we were all scared. Immediately I had women texting me asking what this meant for them… I had no idea what it meant. No body did but somehow I was expected too. In those first few days like everyone I was worried for my family especially my sick Dad and my daughter who had recently been diagnosed with an autoimmune disease. I was scared for myself and I was scared for my women… I had no idea how I was meant to work and social distance and keep myself and others safe. How do I do that when I am in everyone’s bubble? Jumping from bubble to bubble and the responsibility and fear I had surrounding that. I work with well mamas and babies but also high risk mamas and babies. Plus the risk to my own family. The responsibility was and is enormous.

The texts, phone calls and questions were/are endless. I have had phone calls while working with birthing woman about “breaking news”… and trying to calm women but also prioritizing care. I hadn’t even seen the news myself and certainly had no directive from the MOH or the College of Midwives at that stage but there was/ still an expectation that i should know.

I have had to completely change how i run my clinics and postnatals, I have women cry in my clinic, new mums needing a reassuring hug and I cant… Ive not cuddled a baby for too long now. It breaks our hearts. The lovely part of our job… the bit that people say “oh it must be so lovely doing blah blah” is gone… for now. Its been really REALLY hard. And like you I also miss MY people… I cant wait to hug and see my dad.

Amongst all this I still have the hard stuff. The hard discussions, miscarriage, domestic violence, social issues, emergencies and the long long longgg days and nights, plus all the paperwork. I easily worked 32 hours this last weekend, much of it unpaid.

Please take a moment to sit with that experience. It makes me want to cry every time I read it. To rub salt in the wound is that midwives are still trapped in an outdated system of pay which means, unlike other health professionals such GPs and pharmacists, they get zero compensation for the extra work they are doing through COVID-19. Even before COVID-19 hit they were frequently working below minimum wage or, as the NZ Institute of Economic Research in March found, community-based midwives are providing up to 26% of care for free.

Worldwide, women are still undervalued. Both as givers of care and receivers of care. Maternal depression and suicide is still a huge issue in New Zealand and has long lasting ramifications. Midwives are on the frontline of ensuring women and babies health. When there’s not enough midwives, when midwives are too stressed, overworked, burdened to provide the good quality care they normally give and want to give, women, parents, babies, families suffer… our whole society suffers. Midwives are literally helping to shape the future of our people and country.

If you want to look at just the economic side of things, both the WHO and the UN High Level Commission on Health Employment and Economic Growth have shown that investing in midwives makes good economic sense. We see more and more research showing that supporting women in general is good for economies.
Ethically, morally, compassionately… it’s not just about the economy and facts and statistics and numbers. It’s about real women who do real work who deserve equality and equity.

So I will ask you this – why are such a fundamentally important group like midwives still being woefully underpaid by a system that has seen little change since 1990 (30 years!)? Why have midwives spent the last 5 years fighting for recognition and pay equity only to be, “Never prioritised, ignored, and the work of women taken for granted whenever the next demand for funds comes along.” as two of our Wellington midwives, succinctly put it.
Why? Midwifery is a fundamental necessity. And one, as a mother yourself, I’m sure you can appreciate. So again, I ask you, why?

The simple answer is, there is no good reason. The simple answer is, midwives deserve and need to be paid a fair and equitable wage. The funding model co-designed by midwives and the Ministry of Health that has been fought so hard for needs to be implemented.

You once said, “One of the many special people we have been so grateful for over these past few months, our wonderful midwife Libby. Not only is she incredible at what she does, this morning she made me macaroni and cheese because she heard me mention a wee craving yesterday. Thank you so much for everything Libby!”

Our midwives go above and beyond. It’s time we did the same for them.

Further Reading

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